Journal
AMERICAN JOURNAL OF MEDICINE
Volume 130, Issue 3, Pages 372-375Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2016.09.011
Keywords
Cirrhosis; Hypervolemic hyponatremia; Hyponatremia; Tolvaptan; Vasopressin
Categories
Funding
- FIS [PI12/00330]
- ISCIII-Subdireccion General de Evaluacion
- European Regional Development Fund
- Instituto de Salud Carlos III (Rio Hortega fellowship)
- Institucio Catalana de Recerca i Estudis Avancats (ICREA) Academia Award
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BACKGROUND: Vaptans, vasopressin selective V2-receptor antagonists, represent the first pharmacologic approach to the treatment of hypervolemic hyponatremia in cirrhosis. However, information on the use of vaptans for patients with cirrhosis and hyponatremia in a real- life scenario is limited. Therefore, this study evaluated the effect of tolvaptan on serum sodium in patients with cirrhosis and severe hypervolemic hyponatremia. METHODS: Nine patients with cirrhosis and serum sodium <= 125 mEq/L were included. RESULTS: Only 2 of the 9 patients (22%) gained an increase in serum sodium > 130 mEq/L that persisted throughout treatment. In the remaining patients, serum sodium did not change or increased during the first days but decreased thereafter despite continuation of treatment. Only 1 patient developed hyperkalemia as a side effect. CONCLUSIONS: The efficacy of tolvaptan in patients with cirrhosis and severe hypervolemic hyponatremia seems to be limited. (C) 2016 Elsevier Inc. All rights reserved.
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